the mcgill method
The goal of our spine care is to restore lives through the use of the McGill Method. Developed by the foremost spine authority in the world, Professor Stuart McGill, this assessment and treatment approach is about finding the root-cause of your back pain and applying targeted treatment. This complex approach applies principles from anatomy, biomechanics, radiology, exercise science, and ergonomics. Patients who complete an assessment will leave with an understanding of:
- A precise diagnosis in over 95% of cases
- Your unique pain-trigger mechanisms
- How to wind down your pain
- The relationship between your symptoms and your spinal imaging
- Pain-free postures and movement
- An individualized exercise plan
The best roadmap out of back pain is to start with … a clear diagnosis. What this means is you need to learn the exact cause and type of your back problem, and the only way to arrive at that destination is through a detailed clinical history and physical examination, with imaging used as a guide.
The McGill Method examination lasts for three hours. The foundation of healing the spine requires changing the mechanical stresses the injured back experiences–approximately half of the time is to find the cause and the other half is applied toward coaching in posture, movements, and exercises. Learn how to move in a safe manner and rebuild your spine so that you can eliminate pain, increase your athleticism, and get your life back.
This approach integrates the best of medicine, physical therapy, and exercise coaching.
Dr. Lysander Jim is the only Medical Doctor in the world certified as a McGill Method Master Clinician, an elite clinical designation for spine care achieved by only five clinicians in the United States. What this means for you is each assessment reaches a level of scientific rigor and clinical mastery that reaches the exacting standard of the world’s leading spine clinician and scientist.
I am so grateful to Dr. Jim and his care using the McGill method. My problem started over the course of several months when I developed a progressively worsening pain in my buttock. After seeing several providers I eventually received a correct diagnosis of a herniated lumbar disc. However even with a correct diagnosis after a about a month of treatment with NSAIDs and physical therapy my pain continued to get worse and finally exploded to the point where I was unable to work or carry out my activities of daily living.
I then read about the McGill method and was fortunate to find Dr. Jim. The approach is fundamentally different from the current standard of care in that it actually addresses the root cause of the injury. After identifying the mechanism of my injury, Dr. Jim was able to teach me how to re-engineer my movements, and concurrently develop the appropriate musculature to sustain these movements. Now after 2 months of this approach I have seen gradual progress and am now essentially pain free and have been able to return to my life and work. Without Dr. Jim I am virtually certain that I would have needed surgery to alleviate my pain.
As I a physician myself there is no question in my mind that the McGill method should be the standard of care for all back pained patients.
-Ryan Clare, M.D.
I’m 57 year old male and I feel pretty lucky that I’ve had very few back problems in my life. I was surprised to suddenly get excruciating pain in my hip. I went down all the usual paths to treat the issue. I first tried stretching, which didn’t help so then my doctor prescribed physical therapy. Still got worse. Then did the MRI which revealed a bulging disc. I saw an orthopedic surgeon who was very busy and talked to me for about 5 minutes. He told me to keep doing physical therapy and said that if I didn’t see any improvement, I could try the steroid injection or surgery.
I had been suffering for about 5 months and after another 6 weeks of PT it just kept getting worse to the point where I had trouble standing up and sitting down. I felt like I had no other choice but to try the injection. I was still surprised to see that it billed for over $8000. I was encouraged because I started to get some relief right away, but disappointed when the pain had fully returned within a couple weeks.
Luckily, I met Dr. Jim and the things he said made a lot of sense to me. He explained that the health system is not really set up to solve the problems of chronic back pain. It’s designed to give quick relief of symptoms rather than a lasting solution or cure. If pills, shots, or surgery don’t work your pretty much out of options. Dr. Jim explained that because I was relatively healthy, he felt that I should be able to work towards a lasting cure and that hope got me interested and inspired to work towards my cure.
Dr. Jim was extremely sympathetic, and his in-depth analysis started to give me hope that there really may be a solution to my pain. He explained that he was familiar with the 5-minute experience I had with my orthopedic surgeon. After a thorough analysis of my MRI, my movement habits, and pain he figured out what was causing my injury, explained what back hygiene was to me, and showed me many of the day-to-day behaviors I was doing that were causing my problem. Some of my problems were caused by the PT that was supposed to be curing me.
I could tell he was genuinely trying to solve my problem; he was intently listening, and I could tell that it was in his interest to see me cured. Not only did he take more time and effort than my orthopedic surgeon, but he also took more time and effort than any doctor I’ve ever had. He told me that I should be able to fix my problems with the correct exercises, back hygiene, and some time to heal. I was hopeful but skeptical because the pain was becoming debilitating. I left his office not sure it was going to work, but I was sure I got my monies worth because of the effort time and consideration he put into my case. I’ve never had any doctor take this kind of time, energy, and commitment to really understand and analyze my problem. He also followed up with me several times when I had questions.
Dr Jim showed me how the physical therapy exercises I was told to do were making my injury worse. Dr Jim’s approach was to slowly strengthen and loosen at the same time, allowing my back to heal and gently get stronger to allow the healing process. I started doing the exercise and practicing good back hygiene and sometimes I wondered if I would ever get back to normal, but after a few weeks I had a dramatic improvement and within months I started to have many days that were pain free. It was about eight months later I woke up one day and wondered why I couldn’t feel any pain. The pain had been minimal for a few months, but now it’s hard for me to even remember what the pain felt like. I feel like I’m 100% recovered and now I am practicing the back hygiene unconsciously because the daily practice helped me break bad habits the let the healing take.
Chronic lower back pain affects every day of your life. It feels hopeless when ordinary motions like sitting up in the morning or hugging a loved one trigger pain but medical professionals don’t seem to have a real solution. That’s how I felt for two years after injuring my lower back. I came to feel that my best days were gone and I’d have to accept that my body would never feel strong and functional again. That is, until I visited Dr. Jim at my brother’s insistence. In a warm and friendly way, Dr. Jim walked me through an examination of the mechanics of my lower-back pain then proposed a plan of action that would allow me to live pain-free, without surgery or pharmaceuticals. Dr. Jim’s approach makes a lot of sense and I’m grateful to him for helping me regain my health and my hope.
My wife and I both suffered lower back problems several years ago. We were treated symptomatically, but little real progress was made in understanding and treating the underlying cause of our problems. PT, chiropractic, injections, medication, etc. provided a certain measure of relief, but long standing improvement and understanding of what to avoid were missing. Because I had undergone previous treatment with the methods of Dr. Stuart McGill, Dr. Jim was recommended as a possible source of help. Not only is he a McGill Method Master Clinician, but he is the only such clinician in the world with an MD degree. My wife and I both began treatment with him. Our first sessions were thorough, involving a detailed history, examination, and design/demonstration of an exercise program, followed by several monthly sessions. As of this writing, we are both greatly improved!! We understand the movement triggers for our back pain and are strengthening muscles that facilitate proper movement.
-GEORGE SANDERS, M.D.
I saw Dr. Lysander Jim after years of back pain due to injuries from weightlifting and an auto accident. I had previously been treated by a chiropractor who performed a violent adjustment that left me screaming in pain, and a physical therapist who prescribed roman chair back extensions that exacerbated my problem. I recently read about the back injury work of Stuart McGill and thought I’d have to fly to Canada for treatment, but I found Dr. Jim through the McGill website. Dr. Jim spent a great deal of time evaluating me, and putting me through various movements. He explained exactly what my injuries are, and what kind of exercises and movements a person with my body type should avoid. I have always had trouble doing deep squats and deadlifts, and have consistently been told by medical practitioners that I am too tight and just need to stretch more. Dr. Jim explained that due to my genetic hip structure, I simply cannot squat the way some people can. It is not due to tightness. It is due to Western European ancestry. And all those movements I’d been trying to do are actually hurting me. He also explained that the bent over stretching exercises I had previously been prescribed are awful for someone with disk issues. (Very few medical practitioners recognize this.) Dr. Jim created a detailed and personalized exercise and stretching program that is easy in the beginning, but progresses to much more strenous movements. I have had no injury flare ups since seeing Dr. Jim, which is something that has never happened before. I am very diligent in doing the exercises, which you must be to get the results you want. I cannot recommend him enough.
Although it took a trip from Northern California, where I reside, to Pasadena to keep my appointment with Dr. Lysander, I am very glad I made that trip several weeks after my back recovered from the Dec 30 episode enough to travel. During an appointment lasting several hours, Dr. Jim thoroughly assessed my condition and was able to give me a clear and specific diagnosis that clarified the nature and location of the spinal lesion that has been the source of my lumbar spine problem. He identified specific movement patterns that I need to cultivate to avoid this problem in future, and taught me exercises designed to further strengthen those specific movements. Finally, he corrected some mistakes I was making in my 3-year practice of the McGill methods, mistakes that I believe (in spite of all my progress) left my spine still vulnerable to the unexpected acute episode in December. I highly recommend Dr. Jim Lysander to anyone seeking help with managing their Low Back Pain.
I have spondylolisthesis. As my lower-back pain became more constant and severe it forced me to become more sober. I was not invincible. My skeletal structure wasn’t going to fix itself. So I sought more information. I got some tests done and was given a list of shall-nots (don’t get a gut, don’t do heavy squats, don’t sleep on my stomach, etc.). That seemed lacking. I wanted to proactively better my situation. Fortunately, a friend put Dr. Stuart McGill on my radar. I consumed his content and began to employ his spine hygiene method. But as with most things, the value of hands-on experience cannot be understated. Thus I was ecstatic to learn that Lysander Jim — one of only 15 McGill Method Master Clinician’s in the world, and the only medical doctor — was four short hours from my location. I soon had an appointment scheduled.
My spinal assessment with Dr. Lysander Jim was thorough and informative. He helped me to better understand my own pain triggers and in a hands-on yet extremely comfortable way, worked with me to refine my movement patterns. Dr. Jim’s patience, clarity, and joyful demeanor throughout meant that I left the clinic empowered — with more knowledge and confidence that I can constructively address my lower-back issue and live a pain-free (and surgery-free) life
I was experiencing sciatica due to a herniated disk in my L4/L5 area which became so severe I could no longer work. I was seeing doctors through the insurance network but they were not able to do much for me other than recommend some medication which brought no relief (I did not want opioids). A friend recommended the book Back Mechanic, and some basic instruction from the book reduced the pain level to where I could work, but I still experienced great discomfort on a daily basis.
Soon after I went to see a McGill certified specialist Dr. Lysander Jim, and with the assessment and coaching provided during my encounter followed by several weeks of exercise (additional coaching was crucial), I experienced an immense improvement in my day to day pain levels. I have a new and more nuanced understanding of the triggers which cause my pain and more effective ways to remedy when needed.
The assessment and coaching was tailored to me, which is something which was lacking in books or internet forums which are filled with conflicting advice dispensed to a crowd but not actually suitable for any individual. In speaking to other friends and family with back pain, I find that every person’s experience seems to be a little different, and I think this is the biggest difference in seeing a McGill specialist vs other specialists: that you get individual, high level assessment from a practitioner who has blocked off a large chunk of time specifically for you.
-US Military Veteran
I have suffered from a very severe low back injury for over 50 years since I was 15 years old. Until Dr Jim, not one doctor or other practitioner has ever given me a sensible description of how my spine was injured that led to a lifetime of pain, and what might reliably be done about it.
I saw multiple chiropractors, and all of them tried their best in good faith using their standard bag of tools; acupuncture specialists who could possibly relieve pain temporarily but it would immediately return when I began to move again; MDs who routinely offered drugs; an old-time (my age) good guy GP who said he had the same problem, and who had thrown up his hands and relied on heavy duty Tylenol and rest when it really hurt; a pain center that had two solutions and no others, surgery or an incredibly dangerous spinal shot several times of year at great cost and risk each time; a D.O who identified the source of the pain 8 inches higher on the spine that it actually is, but who persuaded me to stop exercising at the age of 50, with terrible consequences in a degrading musculature; yoga, karate, diet, strenuous exercise, no exercise, weightlifting, avoiding weightlifting, swimming, avoiding swimming, and the list goes on.
I tried each and every one and things either did not get better or got much worse, but in each case, I had no idea why things would either not get better or get worse. In other words I had no hypothesis about what was happening in my spine that I could test. Without understanding what was happening, practitioners would say “try this,” and if it didn’t work, there could be no follow up because there was no insight about what was actually happening in my back.
In the first 30 minutes of our first appointment, after interviewing and testing me about various forms of movement that cause pain, Dr Jim used careful but vigorous palpation and probing along and in between the vertebra to identify the precise location of the pain, and the forms of movement that trigger the pain. From that, he deduced what was happening within the spine.
He explained how the injury “destabilized” the L3 vertebra, so it is moving around much more than it should independently of the vertebrae above and below it, why that leads to what feels like random and uncontrollable pain, and what can be done to reduce the incidence and severity of the pain. He gave me instruction and confidence about what I can do to avoid re-triggering the pain for the most part, and what I can do to gradually (over the course of at least a year or more) improve enough to engage in ordinary pleasures: traveling, hiking, even dancing and swimming. He gave me realistic estimates of the time necessary to move toward something approximating recovery, based on the time it takes the body to grow or amend cartilage structures.
He cautioned against expecting a full recovery. That is comforting, because the tendency is to desperately seek a “cure” that will permanently relieve me from the pain. That leads only to frustration, and then hopelessness if a permanent “cure” is the only thing you’ll be satisfied with. He offered no magic “cure,” and avoided the false hope of instant relief using drugs or surgery.
He recommended as much as a year of very carefully avoiding the movements that retrigger the pain, and that break down structures that might otherwise help stabilize the vertebra. This is a common sense executable plan of recovery, and gives me the first hope I’ve had in 50 years that things can get better over time, and in ways that I can understand and influence by controlling my movements.
I’ve been working with Dr Jim for five months now, and I know what I’m doing wrong and when I’m doing it right. That in itself is a victory. I’ve learned the right kind of chair to sit in, and that by itself has substantially increased my productivity as a lawyer. He even suggested exercises to strengthen the area, but without triggering further pain.
I’m looking forward to a more active and less painful life.